Health-care associated bacteremia in geriatric cancer patients with febrile neutropenia
| Autor: | Deniz Akduman, Hande Aydemir, Ayla Gökmen, Furuzan Kokturk, Nihal Pişkin |
|---|---|
| Přispěvatelé: | Zonguldak Bülent Ecevit Üniversitesi |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Neutropenia Febrile neutropenia Bacteremia beta-Lactamases Elderly Staphylococcus epidermidis Risk Factors Internal medicine Neoplasms Epidemiology medicine Escherichia coli Humans Risk factor Mortality Intensive care medicine Aged Retrospective Studies Aged 80 and over Univariate analysis Cross Infection Malignant biology business.industry Mortality rate Middle Aged medicine.disease biology.organism_classification Oncology Multivariate Analysis Female Methicillin Resistance Geriatrics and Gerontology business |
| Popis: | Objective: The aim of this study was to determine the epidemiology, clinical manifestations, and outcome of health-care associated bacteremia in geriatric cancer patients with febrile neutropenia. Materials and Methods: We retrospectively evaluated cancer patients with febrile neutropenia aged ? 60. years with culture proven health-care associated bacteremia between January 2005 and December 2011. The date of the first positive blood culture was regarded as the date of bacteremia onset. Primary outcome was the infection related mortality, defined as the death within 14. days of bacteremia onset. Results: The two most common pathogens responsible for bacteremia were Staphylococcus epidermidis (36.1%) and Escherichia coli (31.5%), with high rates of methicillin resistance and extended-spectrum ß-lactamase (ESBL) production, respectively. There were no statistically significant differences in infection related mortality rate according to the type of malignancy (p. =0.776). By the univariate analysis, factors associated with 14. day mortality among febrile neutropenic episodes were prolonged neutropenia (p. =0.024), persistent fever (p. =0.001), hospitalization in ICU (p < 0.001) and the initial clinical presentations including respiratory failure (p < 0.001), hepatic failure (p. =0.013), hematological failure (p < 0.001), neurological failure (p < 0.001), severe sepsis (p < 0.001), and septic shock (p. =0.036). Multivariate analysis showed that persistent fever was an independent factor associated with infection related mortality (odds ratio, 18.0; 95% confidence interval, 5.2-62.6; p < 0.001). Conclusions: The only independent risk factor for mortality was persistent fever. Although the most frequently isolated pathogens were S. epidermidis and E. coli, high rates of methicillin resistance and ESBL production were found respectively. © 2012 Elsevier Inc. |
| Databáze: | OpenAIRE |
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